title: Operative treatment for scaphoid osteonecrosis (Preiser disease): salvage or excision? Report on two cases and a review of the literature.
abstract: Idiopathic avascular necrosis of the scaphoid, or Preiser disease, is a rare condition. Both the etiology and the pathology are still not well understood. We here present 2 cases with this disease and discuss the recommended treatment according to the stage of disease progression and by reference to previous studies in the literature. Similar to Kienböck disease, the recommended treatment should be selected according to the degree of disease progression. We believe that vascularized bone graft should be restricted to Herbert stage I or II cases with no evidence of radiocarpal arthritis or carpal instability. Our first case showed excellent revascularization following vascularized bone graft, as revealed by magnetic resonance image findings. The presence of arthrosis of the radiocarpal or mid-carpal joints is an indication for scaphoid excision with midcarpal fusion or proximal row carpectomy.
authors.affiliation: From the *Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Yamaguchi; and †Department of Orthopedic Surgery, Ehime Rosai Hospital, Ehime, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Muramatsu
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tominaga
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Taguchi
authors.forename: Kenji
authors.initials: K
authors.lastname: Kido
mesh_terms: D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D007085:Ilium / Q000098:blood supply / Q000637:transplantation*; D008875:Middle Aged; D010020:Osteonecrosis / Q000175:diagnosis / Q000601:surgery*; D011859:Radiography; D011884:Radius / Q000098:blood supply / Q000637:transplantation*; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*